In this article we present the ANS 2022 retrospective with the main highlights recently published on the Gov.br website. According to ANS, supplementary healthcare in Brazil reached important milestones in 2022, such as end the year with more than 50.2 million health plan beneficiaries and more than 30.7 million customers of exclusively dental plans.
More than 500,000 visits to beneficiaries in the Unified Health System (SUS) were notified to operators and around R$ 945 million were transferred to the National Health Fund as part of the SUS Reimbursement process.
The inclusion of 49 items in the List of Health Procedures and Events It was also one of the main highlights of the year in the health insurance sector.
A resumption of in-person activities, however, impacted supplementary health, as expected, with reflection on accident rates. The global economic scenario also influenced healthcare costs and there are still effects of the pandemic on the sector's input chain.
It was a challenging year for the sector, but in the end it presented a positive and hopeful scenario.
Check out the ANS highlights below and at the end, pay attention to our tip for your healthcare provider to structure itself to truly GROW in 2023!
ANS 2022 Retrospective:
Sector growth
At a continuous rate of growth, since July 2020, the sector has registered 50.2 million beneficiaries in medical assistance plans in October 2022 (1.6 million more than in October 2021); and 30.7 million beneficiaries in exclusively dental plans (2.2 million more than in the same period in 2021). São Paulo, Minas Gerais and Rio de Janeiro are the states that have shown the biggest gain in absolute numbers in both modalities.
The ANS in 2022
This was the year in which ANS completed its staff with five effective directors.
Throughout 2022, 8 public hearings and 16 public consultations were held. Furthermore, ANS signed important partnerships, such as the signing of 46 technical cooperation agreements in the Citizenship Partners Program.
Diligent about adopting the best regulatory practices and attentive to the global economic scenario, the ANS Collegiate Board of Directors approved a set of proposals to simplify the prudential regulation obligations of health plan operators, with the aim of reducing bureaucracy and facilitating financial planning of operators with measures that make deadlines more flexible and eliminate requirements in a safe way, without risks to the provision of assistance to health plan users.
Furthermore, ANS approved the consolidation of the regulatory capital standard that modernizes prudential rules, including the last risk component (market risk) to the others already regulated, fulfilling the commitment to publish the standard by 31/12/2022.
It is also worth highlighting the “kick-start” given to the regulatory sandbox process, with the first conversations with the sector to model a controlled environment to promote innovation in health, through economic-financial regulatory incentives.
With a focus on the consumer, ANS carried out the ANS com Você action, a series of events in the five regions of Brazil to bring the regulator closer to consumers. The idea was to expand access to information, so that the public understands the sector's rules and knows their rights and duties.
Through the Citizenship Partners Program, ANS held, with the support of the National Council of Justice (CNJ), the Supplementary Health in Focus event, with the aim of sharing information on technical and regulatory aspects that govern the sector, contributing to the formation of opinion of everyone who works in processes involving health plans.
List of mandatory coverages
Without a doubt, one of the main supplementary health topics of the year was the List of Health Procedures and Events.
With an update process based on the continuous flow of receipt and analysis of proposals, the review of the list became more dynamic, agile and accessible, ensuring extensive social participation and guaranteeing the safety, efficacy and effectiveness of the health procedures and events incorporated.
In 2022, 15 updates were made, which included, among procedures, medications, indications or extensions of use, a total of 49 items. Among them, the list received important achievements such as the rapid test for diagnosing Covid-19; test for Monkeypox disease; Liver transplant; oral chemotherapy drugs; methods for treating Autism Spectrum Disorder (ASD); and end of the limit on the number of consultations with psychologists, occupational therapists, physiotherapists and speech therapists.
On 12/16, RN 555/2022 was published, a new normative resolution that provides for the procedural rite of updating the List of Procedures and Events in Health.
Conflict mediation
In relation to monitoring the service provided by operators to their beneficiaries, the Preliminary Intermediation Notification (NIP) completed 12 years and continues to be an important tool for streamlining and resolving consumer demands, both in relation to issues of an assistance nature and to complaints of a non-assistance nature, with resolution percentages that remain, year after year, above 90%.
Increased interest in portability of needs
The search for plan options for portability of needs increased by 2.1% in the first seven months of 2022, compared to the second half of 2021. The data was extracted from the monitoring report on portability protocols issued by the ANS Health Plans Guide , the Agency's consultation tool for contracting and exchanging health plans. The main reason given by users of the ANS Guide was the search for cheaper health plans.
Promotion of health and quality of life
In 2022, the Agency maintained its programs aimed at qualifying the sector.
In May, ANS brought together leaders of the Proper Birth Movement. Since the program began in 2015, Proper Birth has avoided more than 20,000 unnecessary cesarean sections.
Regarding actions aimed at improving the quality of health care, in 2022, we have 1,183 Health Promotion and Risk and Disease Prevention programs (Promoprev), with 622 programs approved by the ANS and 561 reported to the ANS.
Regarding Qualiss – a project that encourages the qualification of health service providers (hospitals, clinics, laboratories and health professionals) – this year, ANS began collecting quality indicators from voluntary hospitals through the Indicator System Hospitals, SIHOSP. The initiative will create, for the first time, statistics based on quality indicators for service providers working in supplementary health.
To encourage the adoption of innovative models, which prioritize the improvement of healthcare and the sustainability of the sector, ANS encourages operators to implement value-based remuneration models. In November, the Agency launched the project's second notice, with 16 vacancies for operators to present their proposals.
Awareness campaigns: colors that promote health all year round
A more digital Agency
The ANS Digital Transformation Plan completed two years, achieving important advances and improving service to users. Currently, ANS has 100% of digital services, at different levels.
In 2022, the Agency also advanced in one of today's cutting-edge topics: Artificial Intelligence.
Structure your operator to GROW in accordance with ANS
Based on all this information, we can conclude that 2022 was a positive year for the sector, marked by challenges and uncertainties, but it brought back hope and a lot of learning, after the emergency health boom around the world.
Now it's time to look to the future and prepare your health plan operator to truly GROW this year. And to achieve this, the first step is to structure the entire medical audit process, shielding your operator and eliminating a series of problems, such as billing errors, losses with healthcare costs, disallowances, etc. That's where SAUDI comes in, the most awarded Medical Audit System in the country and used by dozens of operators throughout Brazil, especially some of the largest.
With SAUDI you automate the entire medical bill management process, keep your operator in compliance with ANS requirements, almost eliminate 100% glosses, customize mobile application to improve your customer service and much more.
With an intuitive interface, SAUDI is very easy to use and therefore provides a notable optimization of the team's performance in daily and strategic tasks, because it has a customizable dashboard according to the interests of each manager.
Don't let your operator fall behind, start 2023 confident to GROW! Schedule right now a quick presentation of SAUDI with one of our experts.
